布地奈德雾化吸入联合穴位贴敷治疗小儿急性喘息性支气管炎的临床疗效分析

目的研究布地奈德雾化吸入联合穴位贴敷治疗小儿急性喘息性支气管炎的临床疗效。方法根据随机数字表法将本院2018年1～9月期间接收的急性喘息性支气管炎患儿52例分为对照组和观察组,每组26例,前一组采取布地奈德雾化吸入治疗,后一组加用穴位贴敷治疗。将两组急性喘息性支气管炎患儿的临床效果、临床症体征缓解时间、肺功能指标、不良反应发生情况进行比对。结果观察组急性喘息性支气管炎患儿的临床总有效率(92.31%)高于对照组,差异有统计学意义(P 0.05);观察组咳嗽、咳痰、喘憋、肺部体征的缓解时间均短于对照组(P 0.05);观察组治疗后的呼吸频率低于对照组,潮气量、最大呼气流量均高于对照组,差异有统计学意义(P 0.05);两组患儿的不良反应发生情况对比差异无统计学意义。结论为急性喘息性支气管炎患儿采用布地奈德雾化吸入联合穴位贴敷治疗安全有效,有助于患儿临床症状体征的缓解和肺功能的改善。     

中药贴敷理疗辅助治疗小儿支气管肺炎临床观察

目的:研究中药贴膏穴位贴敷对治疗小儿支气管肺炎的疗效。方法:将支气管肺炎患儿随机分为治疗组108例,在西医治疗的基础上加用中药膏贴穴位贴敷;对照组100例给予西医常规治疗。1疗程后观察两组患儿咳嗽症状及肺部体征变化。结果:治疗组患儿咳嗽症状及肺部症状在治疗3天后明显好转101例,对照组有81例。结论:中药贴敷理疗对治疗小儿支气管肺炎有显著的疗效。     

孟鲁司特钠联合咳喘三伏贴对哮喘患儿血清IL-4和IFN-γ水平的影响及其机制

目的探讨孟鲁司特钠联合咳喘三伏贴穴位贴敷对哮喘患儿血清白介素-4(IL-4)和干扰素-γ(IFN-γ)水平的影响及其机制。方法将67例哮喘患儿按照治疗方法分为对照组(n=33)与观察组(n=34)。2组患儿均给予常规治疗,包括抗感染、镇咳以及布地奈德吸入等常规治疗方法进行治疗;在此基础上,对照组给予孟鲁司特钠,观察组在对照组基础上采用穴位贴敷咳喘三伏贴进行治疗。比较2组临床疗效、患儿治疗后相关临床症状积分、患儿治疗前后各项免疫指标水平、治疗前后血清IL-4及IFN-γ的水平变化。结果 (1)经治疗,观察组临床总有效率为94.12%,显著高于对照组(75.76%)(P<0.05);(2)观察组患儿哮喘发作情况、易感冒、盗汗及鼻塞、打喷嚏积分均显著低于对照组(P<0.05);(3)2组患儿治疗后IgE、CD8~+水平均显著低于治疗前(P<0.05~0.01),2组患儿治疗后CD3~+、CD4~+及CD4~+/CD8~+水平均显著高于治疗前(P<0.05~0.01);(4)2组患儿治疗后血清IL-4水平均显著低于治疗前(P<0.05,P<0.01),2组患儿治疗后血清IFN-γ水平均显著高于治疗前(P<0.05),且2组患儿治疗后血清IL-4及IFN-γ水平差异均具有统计学意义(P<0.05)。结论孟鲁司特钠联合哮喘三伏贴穴位贴敷能够显著改善患儿哮喘的临床症状及体征,其发挥疗效的机制可能与改善患儿机体免疫功能及血清中相关炎性因子(IL-4、IFN-γ)水平相关。     

喘可治穴位注射联合穴位贴敷对COPD患者发作期治疗效果的观察

目的:探讨喘可治穴位注射联合穴位贴敷对COPD患者发作期治疗效果。方法:选择某院2017年7月～2018年7月间收治的100例慢性阻塞性肺病患者,随机平均分为两组,对照组患者给予常规西医治疗,实验组患者给予喘可治穴位注射联合穴位贴敷治疗,对两组患者的临床疗效、体征及中医病症情况进行对比。结果:实验组患者各项体征指标分低于对照组患者(P0.01);实验组患者各项中医体征评分分别显著高于对照组患者。结论:喘可治穴位注射联合穴位贴敷治疗慢性阻塞性肺病,可有效提高临床疗效,改善患者各项临床指标,从而改善患者的生活质量。     

中药穴位贴敷联合耳穴压豆在小儿支气管哮喘中的临床护理应用

目的在小儿支气管哮喘患儿进行护理时使用中药穴位贴敷联合耳穴压豆对小儿支气管哮喘进行辅助治疗,观察中药穴位贴敷联合的临床护理应用效果。方法选取2017年4月至2018年4月在我院接受治疗的98例小儿支气管患儿作为调查对象,按照随机性的原则平均分为实验组和对照组,每组49例,实验组在进行常规治疗的基础上使用中药穴位贴敷联合耳穴压豆进行治疗,对照组使用常规治疗。结果使用中药穴位贴敷联合耳穴压豆机型辅助治疗的实验组患儿恢复的更快,治疗的有效率更高而且对护理的满意度更高。结论在护理时使用中药穴位贴敷联合耳穴压豆进行治疗不仅可以有效的帮助患儿改善病情,而且可以提高患儿对护理治疗的接受度。     

穴位贴敷配合中药保留灌肠治疗慢性盆腔炎的疗效观察及护理

目的:探讨应用穴位贴敷配合中药保留灌肠治疗护理方案在治疗慢性盆腔炎方面的临床疗效。方法:选取2012年5月—2015年1月接受治疗的120例慢性盆腔炎患者为研究对象,随机分为对照组和观察组,每组60例,对照组采用中药保留灌肠并辅助相应护理干预,而观察组在此治疗基础上实施穴位贴敷治疗。对两组患者的临床体征恢复时间、临床效果以及不良反应进行统计学分析对比。结果:观察组和对照组总有效率分别为96.67%和83.33%,且观察组显效时间显著短于对照组,差异有统计学意义(P<0.05)。结论:穴位贴敷配合中药保留灌肠治疗及护理方案在治疗慢性盆腔炎方面效果较好。     

穴位贴敷联合中频脉冲电治疗仪治疗骨质疏松患者的意义分析

目的 探讨骨质疏松患者采取穴位贴敷联合中频脉冲电治疗仪治疗的意义。方法 60例骨质疏松患者,随机分为对照组及试验组,每组30例。对照组采取常规干预,试验组在对照组的基础上采用穴位贴敷联合中频脉冲电治疗仪治疗。比较两组临床疗效及治疗前后症状、体征、生活质量评分。结果 试验组治疗总有效率为93.33%,高于对照组的70.00%,差异有统计学意义(P<0.05)。试验组患者症状评分(2.92±0.53)分、体征评分(3.87±1.91)分低于对照组的(5.13±1.31)、(5.81±1.83)分,生活质量评分(88.74±2.41)分高于对照组的(74.22±3.66)分,差异有统计学意义(P<0.05)。结论 穴位贴敷联合中频脉冲电治疗仪对骨质疏松患者的疗效显著,值得临床推广。     

中西医结合治疗小儿积滞乳食内积证40例临床观察

目的观察双歧杆菌颗粒口服联合消积化滞膏贴敷治疗小儿积滞乳食内积证的临床疗效。方法将80例小儿积滞乳食内积证患儿随机分为对照组和治疗组,各40例。对照组予双歧杆菌颗粒口服治疗,治疗组在对照组治疗方法的基础上加用消积化滞膏贴敷。2组均连续治疗6 d后统计疗效。结果治疗前2组中医症状积分比较,差异无统计学意义(P0.05),具有可比性。治疗后2组中医症状积分均较同组治疗前明显降低,差异均有统计学意义(P0.05),且治疗组下降更显著(P0.05)。治疗组痊显率为82.5%,明显优于对照组的55.0%,2组比较,差异有统计学意义(P0.05)。结论双歧杆菌颗粒口服联合消积化滞膏贴敷治疗小儿积滞乳食内积证,疗效确切,操作简单,值得临床推广运用。     

杏苏散加味联合红外止咳贴穴位贴敷治疗小儿支气管肺炎恢复期30例临床观察

目的观察杏苏散加味联合红外止咳贴穴位贴敷治疗小儿支气管肺炎恢复期的临床疗效及安全性。方法选取支气管肺炎恢复期患儿60例,随机分为对照组和治疗组,各30例。对照组予常规止咳化痰、抗感染等治疗,治疗组予杏苏散加味口服联合红外止咳贴穴位贴敷,治疗10 d后比较2组患儿的临床疗效、主次症积分改善情况及不良反应发生情况。结果治疗组和对照组总有效率分别为80.00%和53.33%,差异有统计学意义(P0.05);治疗组咳嗽、喉间痰鸣主症积分及肺部痰鸣音、鼻塞、咽红、汗多次症积分改善情况均优于对照组,差异有统计学意义(P0.05);治疗组有2例出现轻微不良反应,停药后逐渐消失。结论杏苏散加味联合红外止咳贴穴位贴敷治疗小儿支气管肺炎恢复期临床疗效显著,安全性好,值得临床推广应用。     

穴位贴敷联合内关穴按压对肺源性心脏病患者的意义分析

目的 分析穴位贴敷联合内关穴按压对肺源性心脏病患者的意义。方法 选取60例肺源性心脏病患者进行研究,随机分为对照组和试验组,每组30例。对照组采用临床传统康复治疗,试验组在对照组基础上采用穴位贴敷联合内关穴按压治疗。比较两组运动耐力、心功能改善情况及临床满意度。结果 治疗前,两组6 min步行距离比较差异无统计学意义(P>0.05)。治疗14、28 d,试验组6 min步行距离分别为(321.12±25.67)、(358.76±26.47)m,均长于对照组的(254.34±23.59)、(267.46±24.64)m,差异有统计学意义(P<0.05)。试验组总有效率93.33%明显高于对照组的56.67%,差异有统计学意义(P<0.05)。试验组临床满意度96.67%高于对照组的80.00%,差异有统计学意义(P<0.05)。结论 穴位贴敷联合内关穴按压对肺源性心脏病患者临床效果显著,可改善患者的临床症状,值得推广。     

药源性咳嗽

咳嗽是一种常见的临床症状。引起咳嗽的原因包括原发于上下呼吸道的疾病,如常见的感冒、咽喉炎、鼻窦炎、鼻后滴漏综合征、急性支气管炎、慢性支气管炎、支气管哮喘、支气管扩张等等,其他系统疾病如心力衰竭、胃食管反流性疾病等也可以引起咳嗽,此外可能发生的原因还包括了药物引起的药源性咳嗽。目前已经发现有100种以上药物可以引起肺部损伤,如药物性肺炎、药物性哮喘、药物性肺水肿、药物性肺间质病变、药物性呼吸衰竭等,大部分的药物性肺损伤都会伴有咳嗽的发生。本文主要介绍药源性咳嗽的发病机制及引起药源性咳嗽的药物种类,并重点讨…     

Clinical cough II: therapeutic treatments and management of chronic cough

Chronic cough is a common and frequently disruptive symptom which can be difficult to treat with currently available medicines. Asthma/eosinophilic airway disease and gastro-oesophageal reflux disease are most commonly associated with chronic cough but it may also trouble patients with chronic obstructive pulmonary disease, pulmonary fibrosis and lung cancer. Over the last three decades there have been a number of key advances in the clinical approach to cough and a number of international guidelines on the management of cough have been developed. Despite the undoubted benefit of such initiatives, more effective treatments for cough are urgently needed. The precise pathophysiological mechanisms of chronic cough are unknown but central to the process is sensitization (upregulation) of the cough reflex. One well-recognized clinical consequence of this hypersensitive state is bouts of coughing triggered by apparently trivial provocation such as scents and odours and changes in air temperature. The main objective of new treatments for cough would be to identify ways to downregulate this heightened cough reflex but yet preserve its crucial role in protecting the airway. The combined efforts of clinicians, scientists and the pharmaceutical industry offer most hope for such a treatment breakthrough. The aim of this chapter is to provide some rationale for the current treatment recommendations and to offer some reflections on the management of patients with chronic cough.     

The pharmacology of cough

Cough is an indispensable defensive reflex. Although generally beneficial, cough is also a common symptom of diseases such as asthma, chronic obstructive pulmonary disease (COPD) and lung cancer. Cough remains a major unmet medical need and, although the centrally acting opioids have remained the antitussive drug of choice for decades, such opioids possess many unwanted side-effects. However, new research into the behaviour of airway sensory nerves has provided greater insight into the mechanisms of cough and new avenues for the discovery of novel non-opioid antitussive drugs. In this article, the pathophysiological mechanisms of cough and the implications of this research for the development of novel antitussive drugs will be discussed. A poster depicting the pharmacology of cough is available online and in print as to this article.     

Clinical cough V: complementary and alternative medicine: therapy of cough

We review the actions of complementary and alternative medicines (CAMs) in the treatment of cough and of the conditions associated with it; in particular asthma and upper respiratory tract infections. These therapies may work (1) peripherally, at the sites in the airways and lungs at which cough is being activated, (2) in the brainstem, where the neural "cough center" is situated, or (3) at the cerebral cortex, where cough can be initiated, suppressed or modified by conscious or unconscious controls. Of the large number of trials of CAMs against cough, most are inadequate in design. It may be difficult to randomize selection. Blinding is often impossible both for the patient and the therapist, and adequate placebo controls may be difficult to devise. The patient can usually identify the "active" treatment by the taste or smell of a medicine, or from the approach and apparatus being used. Pure chemicals can be extracted from many of the herbs used as antitussives, and can be shown to be effective in randomized, blind, and controlled trials, but it does not follow that the herb itself, used in the recommended formula and shown to be antitussive, acts by this agency unless a placebo effect is ruled out. A few herbs are identified where the evidence points to a true antitussive action. Of nonherbal treatments, the few positive results are usually outweighed by the larger number of negative ones. Thus, in general, CAMs for cough are welcomed enthusiastically by the patient but lack sound evidence for their efficacy. Antitussive chemicals can be extracted from many herbs, but it is no more than a reasonable hypothesis that the herb itself acts through this pathway.     

辣椒素吸入小鼠咳嗽模型和记录装置的建立

目的　建立辣椒素气雾吸入小鼠咳嗽模型及咳嗽记录装置。方法　用超声雾化器气雾辣椒素 (0 1mmol·L-1)15s引起小鼠咳嗽 ,MedLab生物信号采集处理系统记录咳嗽次数。结果　小鼠 3min内的咳嗽次数为 16 8± 5 0 (n=6 5 )。可待因预先灌胃给药后 ,减少咳嗽次数 ,ID50 95 %可信限为 9 6 9(7 5 6～ 12 42 )mg·kg-1;非镇咳药盐酸麻黄碱2mg·kg-1和 4mg·kg-1预先灌胃无作用。结论　椒素吸入小鼠咳嗽模型是一个很好的筛选镇咳药物模型。通过小鼠咳嗽记录装置可以客观观察试验结果。     

澳特斯小儿止咳露镇咳祛痰疗效与安全性

目的:评价澳特斯小儿止咳露镇咳祛痰疗效及不良反应.方法:采用随机双盲对照试验,对62例有中度以上咳嗽的2～14岁患儿进行治疗,以博士小儿止咳露为对照药.试验组31例,对照组31例,按年龄给予不同的口服剂量,连用3～7d.观察受试者咳嗽、痰量等变化.结果:试验组临床有效率为80.6%,对照组为77.4%,差异无显著性.2组患儿均未发生不良反应.结论:澳特斯小儿止咳露与博士小儿止咳露的临床效果相似.     

Clinical cough III: measuring the cough response in the laboratory

As interest in clinical cough research grows, measurement of cough reflex sensitivity will assume an increasingly important role. With proper equipment and meticulous attention to methodological details, cough reflex sensitivity can be safely, accurately, and reproducibly determined. Such precise measurement allows the evaluation of the effect of pharmacological or nonpharmacological interventions on the sensitivity of the cough reflex, or the comparison of cough reflex sensitivity between different subject populations. In addition to the method, other vital components of optimal cough challenge testing include proper interpretation of data and appropriate selection of study populations.